Provider Demographics
NPI:1689779027
Name:YAPTENGCO, SEAN E (DC)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:E
Last Name:YAPTENGCO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:WINDER
Mailing Address - State:GA
Mailing Address - Zip Code:30680-2277
Mailing Address - Country:US
Mailing Address - Phone:770-867-7032
Mailing Address - Fax:770-867-7047
Practice Address - Street 1:220 E BROAD ST
Practice Address - Street 2:
Practice Address - City:WINDER
Practice Address - State:GA
Practice Address - Zip Code:30680-2277
Practice Address - Country:US
Practice Address - Phone:770-867-7032
Practice Address - Fax:770-867-7047
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA06489111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU86726Medicare UPIN
GA35ZCGMCMedicare ID - Type UnspecifiedPROVIDER NUMBER